Genes Play Role in Racial Heart Failure Differences

Journal's special heart failure issue also discusses need for palliative care during management

By Eric Metcalf

HealthDay Reporter

TUESDAY, July 21 (HealthDay News) -- Gene polymorphisms may explain differences in beta-blocker treatment response in Caucasians and African-Americans with heart failure, and palliative care should be integrated into comprehensive heart failure treatment throughout the course of its management, according to two articles published in the July 28 issue of the Journal of the American College of Cardiology, focusing on heart failure.

In the first paper, Sharon Cresci, M.D., of the Washington University School of Medicine in St. Louis, and colleagues analyzed data from 2,460 Caucasian and African-American patients, most of whom received a beta blocker. All were genotyped for polymorphisms that are more common in African-Americans. They found that polymorphisms of the β1-adrenergic receptor -- the main cardiac target for beta blockers -- as well as the G-protein receptor kinase 5 that terminates its signaling can significantly affect heart failure outcomes. Adjusting for these variants eliminates the racial differences in beta-blocker treatment's effect on survival.

In the other paper, Sarah J. Goodlin, M.D., of Patient-Centered Education and Research in Salt Lake City, writes that supportive care to address psychosocial issues should be provided alongside disease-modifying interventions as part of comprehensive heart failure care. Primary care physicians and cardiologists should align themselves with other types of providers who can offer different aspects of this comprehensive care.

"Although the focus of therapy for many patients is to improve function and defer death, the life-limiting nature of heart failure and increased risk of sudden cardiac death with heart failure should be acknowledged at the time of heart failure diagnosis as part of heart failure patient/family education," Goodlin writes.

Authors on each paper reported financial relationships with outside interests.